Chimmerism and CD3
Hi all
It's been a while since I posted something but was hoping someone could shed some light. I was my brothers donor (haplo) in January this year, he was diagnosed with acute undifferentiated Lukemia which we've been told was very rare... so far everything seems to be going well, he 's caught a few virus' and has had mild GVHD of the mouth and skin but he's managing... or so he says - my brother has never been a big communicator!
Anyway I'll get to the point. we've recieved his letter from his consultant that says his chimmerism 100% his blood is 100% mine and his CD3 cells are 100% mine... he's been off immunosupressents for 10 days now, am I right in thinking that the CD3 cells should start getting progressively lower as he builds his own immunity?
sorry for the long winded msg.
Dannii
Comments
Hi there Dannii.
Thanks for the update. I'm not sure of the significance of the CD3 cells but the fact that the chimerism is 100% donor cells sounds like its worked to me. It means that his own system has been fully replaced by that of the donor, you.
It sounds like a good sign. I was 100% too after a few months and as far as I know it's never dropped from there, I'm not sure whether it can drop from 100% as theoretically there is none of the original system left.
Is he still suffering from GvHD or has that been treated? I had GvHD of the skin which took two years of ECP treatment to cure it, but I haven't had any problems since.
All the best,
Steve
That's filled me with hope Steve, Thank you!
He's still suffering with GVHD and is getting a number of headaches, the doctors are reluctant to put him on the immunosuppresents again. They've mentioned another route which involves cleaning his blood?? is that the ECP treatment that you had?
thanks again for your comment
Dannii
Hi Dannii, yes the cleaning of the blood that you describe does sound like ECP.
ECP is the short term for Extra-Corporeal Photophoresis, which effectively means it is the treatment of blood outside the body. I guess the simplest way to think of it is similar to dialysis where the patient is connected to a machine which cleans the blood. In the case of ECP it isn't taking the place of a faulty function of the body like dialysis but is treating the nuisance cells in the blood that are causing the GvHD.
GvHD is caused by a reaction between the bodies original cells in existing tissue and the new cells in the donor blood system. This causes reactions between the old and new systems which can cause difficulties.
In ECP the treatment involves blood being taken gradually from the patient and passed through a machine which filters out the problematic cells. These are then treated with a photosensitive chemical and UV light before being returned to the patient. The process sort of reprogrammes the problematic donor cells to tolerate the old cells in your body. Over progressive treatments which take a portion of the blood at a time, the number of these problematic cells in the bloodstream gets less and the GvHD symptoms reduce and hopefully disappear completely.
It's a very gradual treatment over a long time and involves regular visits for treatment, but it's not a particularly difficult process to go through and is not uncomfortable, just more time consuming than anything else.
As I understand it there are only a few centres that offer the treatment, and it doesn't always work for everyone, though I believe the success rates are good.
If your brother has the opportunity to try it I can recommend it from my own personal experience, providing he can give the commitment in terms of time. Initially this was two half days every two weeks for me, but as the symptoms improved that was reduced in frequency.
I hope this helps, and if he does go for ECP please let us know how he gets on.
All the best,
Steve